CASE REPORTS   

Chirurgia 2016 June;29(3):83-7

Copyright © 2016 EDIZIONI MINERVA MEDICA

language: English

Emergency stenting for acute internal carotid artery dissection after carotid endarterectomy with indwelling shunt

Michel BATT ¹, Laurent SUISSA ², Jacques SEDAT ³, Sylvain LACHAUD ², Yves CHAU ³, Jean BAQUÉ ³

¹ Department of Vascular Surgery, St Roch Hospital, Université de Nice, Sophia Antipolis, Nice, France; ² Department of Vascular Neurology, St Roch Hospital, Université de Nice, Sophia Antipolis, Nice, France; ³ Department of Interventional Neuro‑Radiology and Interventional Vascular Radiology, St Roch Hospital, Université de Nice, Sophia Antipolis, Nice, France

Minimally invasive aortic valve procedures via mini-sternotomy (mini-AVR) are gaining popularity. Myocardial protection in this setting may bA 61-year-old woman underwent right carotid endarterectomy for asymptomatic stenosis (80%). Routine endarterectomy was performed using a selective shunt. The patient recovered from surgery without any neurologic deficit, but six hours after the operation, she experienced massive left-sided hemiplegia. An urgent MRI showed right-sided Sylvian ischemia with an absence of carotid-sylvian flux. Thrombolysis treatment was inadvisable. Lifesaving mechanical unclogging was performed: carotid stenting enabled us to reestablish the permeability of the internal carotid artery and the flux in the middle cerebral artery. Twenty-four hours after the operation, the patient had made a complete neurological recovery.